{"title":"Gelsolin as a predictor of arteriovenous fistula maturation.","authors":"Rifat Ozmen, Cihan Uysal, Nevzat Herdem, Funda Ipekten, Inayet Gunturk, Aydin Tuncay, Okan Ozocak, Cevat Yazici, Ismail Kocyigit","doi":"10.1007/s10157-025-02655-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gelsolin is a key regulator of actin filament metabolism and plays a role in tissue remodeling. We evaluated plasma gelsolin (pGSN) in predicting arteriovenous fistula (AVF) maturation.</p><p><strong>Methods: </strong>Only patients with newly created radiocephalic AVF were included. pGSN and plasma F-actin levels were measured preoperatively. Maturation was defined as an access (cephalic) vein diameter > 5 mm and a fistula blood flow rate > 500 mL/min in ultrasound, 8 weeks after operation.</p><p><strong>Results: </strong>A total of 68 patients were analyzed with a mean age of 62.6 ± 11.1 years. AVF maturation was identified in 39 patients (57.3%). Mean pGSN level was 4726 (3836-6483) ng/mL in patients with mature AVF and 3237 (2895-4382) ng/mL in patients with immature AVF. pGSN levels were significantly higher (p < 0.001) in the mature AVF group. F-actin levels were not significantly different between two groups. pGSN levels positively correlated with fistula blood flows (r = 0.326, p = 0.007). Multivariate logistic regression analysis revealed that pGSN (p = 0.003) was determined to be an independent risk factor in predicting AVF maturation. Preoperative pGSN levels were significantly predictive of AVF maturation in the ROC analysis. Sensitivity and specificity of pGSN were 82.1% and 58.6%, respectively, with a cut-off value of > 3716 ng/mL and an area under the ROC curve of 0.75 (95% CI: 0.64-0.87, p < 0.001).</p><p><strong>Conclusion: </strong>Current results demonstrated that patients with mature AVFs had significantly higher preoperative pGSN levels compared to those with immature AVFs. Outcomes suggest that pGSN could serve as a predictive biomarker for AVF maturation.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10157-025-02655-2","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Gelsolin is a key regulator of actin filament metabolism and plays a role in tissue remodeling. We evaluated plasma gelsolin (pGSN) in predicting arteriovenous fistula (AVF) maturation.
Methods: Only patients with newly created radiocephalic AVF were included. pGSN and plasma F-actin levels were measured preoperatively. Maturation was defined as an access (cephalic) vein diameter > 5 mm and a fistula blood flow rate > 500 mL/min in ultrasound, 8 weeks after operation.
Results: A total of 68 patients were analyzed with a mean age of 62.6 ± 11.1 years. AVF maturation was identified in 39 patients (57.3%). Mean pGSN level was 4726 (3836-6483) ng/mL in patients with mature AVF and 3237 (2895-4382) ng/mL in patients with immature AVF. pGSN levels were significantly higher (p < 0.001) in the mature AVF group. F-actin levels were not significantly different between two groups. pGSN levels positively correlated with fistula blood flows (r = 0.326, p = 0.007). Multivariate logistic regression analysis revealed that pGSN (p = 0.003) was determined to be an independent risk factor in predicting AVF maturation. Preoperative pGSN levels were significantly predictive of AVF maturation in the ROC analysis. Sensitivity and specificity of pGSN were 82.1% and 58.6%, respectively, with a cut-off value of > 3716 ng/mL and an area under the ROC curve of 0.75 (95% CI: 0.64-0.87, p < 0.001).
Conclusion: Current results demonstrated that patients with mature AVFs had significantly higher preoperative pGSN levels compared to those with immature AVFs. Outcomes suggest that pGSN could serve as a predictive biomarker for AVF maturation.
期刊介绍:
Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.